Healthcare Provider Details

I. General information

NPI: 1689041329
Provider Name (Legal Business Name): NICK HILDRETH MEMORIAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 COURT STREET
ROCKWELL CITY IA
50579-1534
US

IV. Provider business mailing address

401 COURT STREET
ROCKWELL CITY IA
50579-1534
US

V. Phone/Fax

Practice location:
  • Phone: 712-297-2026
  • Fax: 712-297-2019
Mailing address:
  • Phone: 712-297-2026
  • Fax: 712-297-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. KYLIE JANE HILDRETH-RUTHMEIER
Title or Position: ARNP/OWNER
Credential: ARNP
Phone: 712-297-2026